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Hey all. I just got back from the doc, and he started me on Sustiva+Combivir. We talked about a couple diff treatment options, and the side effects, etc, and this one seemed to be better, but...... I am going in for job interviews, as I am currently unemployed (another story). I have worked nights the last 8-10 yrs. I have alwasy worked nights, and my wife does too. I am scared about starting on a medicaion that says to take before bedtime (obviously your supposed to take it the same time each day), but WHICH bedtime? When I work a night shift I will go to bed in the morning. When I am off work, I will typically go to bed at night. My job requires that I stay alert, so should I just take it in the morning all the time then? I don't know? I asked my doc, and he said it should matter when I take it, I just need to take it at the same time, but I am worried. Another option is to just not take a night shift job, although this option will be more difficult on my family-as we will have to find babysitters every day I work, so......you see my dilemma. ANyone that has taken this combination, can you tell me how you did on it? I got my scrpt filled, but haven't started yet (just an hour ago when I got home from the pharmacy). ANy help would be greatly appreciated.Thanx,Brian

I work the night shift. 11:00 PM to 7:00 AM. I've been working that shift for ten years also. I take my meds at 8:00 am and 8:00 Pm . I am on Viramune, Viread and epzicom. I take one viramune and the Epzicom at 8:00AM, and one viramune and the Viread at 8:00 pm. This regemin, and this schedule works fine for me, and while my job is not physically demanding, it does require me to stay quite alert.

If you were to take a nighttime job, you would most likely take the Sustiva, just before going to bed.(Sometime in the morning). If you need to readjust the times you take your medication, you will be able to do that. I would chat a little longer, but I have got to get ready for work. Which means it's time to take that 30 minute hot bath, and relax before going in.

Maybe I didn't make myself clear. Working 5 nights a week and keeping your scheduale the same would be great. I work three twelve hour shifts a week, generally (7pm-7am). It might be in a row, it might not. In the days when I am not working I will sleep nights. So, lets say I get off work at 7 am. If I do NOT have to go back to work that night, I will only sleep for about 4-5 hours. Also, you are taking different medictions that I was prescribed, and the side effects of my meds may be different, but one of them I am supposed to take at bedtime. Now, having said that, the doctor did not mean for me to take it at different times of the day. if I go to bed on tuesday at 9 am, then I wake up at 1pm, and go back to bed at 10 pm, when do I take the med? If I start taking it at night, before I go to bed, what do I do when I have to go to work and be alert at night from 7pm till 7 am?? You see my dilemma?? Maybe I should just chuck the whole night shift thing and find something during the day. As I said, it will be hard on my family, but I have to do whats best for me too.

Hi,I have not been on your specific combo of meds, but I have taken Sustiva in the past. For some people, it can cause sleepiness, dizziness, therefore the suggestion is to take the sustiva before going to sleep so one can sleep through the side effects.

That all being said, everyone responds differently to meds. You may not experience these side effects. If I were in your position, I would take the meds in the AM, since on the days where you sleep during the PM hours I am assuming you will be at home, and better able to tolerate the possible side effects. Since you have to be alert at work, I would not take the meds in the PM.

If taken in the AM, you can sleep at home, or be able to rest easier at home tolerating the side effects. For most, side effects usually last 2-4 weeks.

Which ever you choose, the important thing is to be compliant and consistent with your dosing schedule in order to avoid resistance.

I wish there was more information that I could give you. There is no doubt, that working the schedule that you are on can be difficult, Sustiva can have some very nasty side effects for some, but once again not all, will have those side effects. You are also on Combivir. I am on part of that combo (Epivir) ....for three years now.( no problem with the Epivir )

I was also on the AZT portion of your regimen back in 2004, in the pill form of Trizivir. I was on that for 30 days, until I asked the doctor, to be switched from that medication. I just couldn't work full time and handle the side effects of the AZT. It was a tough 30 day struggle for me. After Trizivir was dropped, everything went well again.

Brian, you stated" Maybe I should just chuck the whole night shift thing and find something during the day. As I said, it will be hard on my family, but I have to do whats best for me too "

You are absolutely right about that. It is something to think about. If the medications are going to be tough on you, with the work schedule you outlined, it may just be too much to handle. Brian, I am not in your shoes, I can't tell you what you should do. I know you will have some tough decisions to make, and I also know what it means to bring home the paycheck.

Whatever you decide on, adherence to the meds, and taking the meds at the same time everyday, is something, that you are not able to avoid, and it is important to take these meds as prescribed, to avoid resistance issues, further down the road. I can not express enough, the importance of this.

If you have problems with the Sustiva/AZT, there are other medications available, that do not have the side effects of Sustiva. But I still got to remind you that everyone can react differently. Brian, make sure to mention these concerns to your doctor, and see if there is something that he may recommend to you.

Also want to mention this to you. In October of 2004, I had to change jobs I was doing, because of the effects of neuropathy. It was was tough being on my feet 8 hours a day at work, and also at that time doing quite physical work, of apartment renovation.

I took a desk job, ( within the same company) with a major cut of pay. but not until I worked out all my expenditures, and realized, just what I needed to live on. I am fortunate to be able to stay with that same company, because the health insurance, dental insurance, 5 weeks vacation a year is great to have,( I was going to do everything in my power to maintain that insurance) It's tough to give that up, but the sacrifice in the job change was well worth it.

When I first started taking Sustiva, and for the following 2 1/2 years, I was working the night shift(midnight to 8am) on weekends. I had the same worry and discussed it with my doctor's nurse. She told me that Sustiva is much more forgiving and needn't be taken at the exact time to stay at therapeutic levels. I also brought this up in these forums and received the same response. During this time, I took my Sustiva about half an hour before going to bed, no matter what time of the day or night. Bedtime usually varied 6 or 7 hours throughout the week and I remained undetectable, other than two very small blips in my viral load.

Same-o situation here. I work three 12hr nights 6pm-6am in a row (always). its HARD! Seems like one loooong night starting wed 6pm and ending sat 6am. Another guy works the same but sun - tues. I always griped if we rotated, that is, the two of us worked every other day, then we'd have a day to recover. But if its not "their" idea, its no idea. They don’t have to work these hours. (I could go on, but wont).

But what I do is take sustiva at 6:30 am when I get off. But I often stay up till 10am. This use to be a problem but now the sustiva sides only hit me in a small way and I can push thru them.. When they do hit, it only lasts 1 to 2 hours of that "weirdness" feeling. I find or have found what I can do and not do when feeling the sides. Like, I wouldn’t want to figure my check book during that 2 hours, I cant concentrate good enough to trust myself. And I have this friend that loves to call me every morning at 7am and talk my leg off for 2 hours. Its a one way conversation, usually, me listening to him go on and on. He works aw walmart as a cashier and has to tell me every awful happening he encountered, and the poop on walmart too. If I go thru this every day, on sustiva sides, I get a real pain in the head. Like he drives me nutz after 30 min or so. So I found I can only talk (or listen) to him once a week. He leaves long msgs on the machine the other days till he is timed out by the machine.Anyway, I found what I can do and cant do, while feeling the sides. and I stick to that.

Then there are the non work nights when I still take sustiva at 6:30am, and stay up maybe till noon or 1pm. I feel the sustiva buzz for a couple hours, but can push thru it. It really doesn’t stop me from anything. There are days however where the sustiva knocks me out, so I just go to bed. It lets me sleep pretty sound.

Soooo, I'd suggest you take sustiva after work (before bed), same time every day. And the same time on non work days. On the work days, you can go to bed and sleep it off. On the non work days, I think you'll find you can push thru that couple of hours (if you stay up), then suddenly you feel ok again.

I know, its a hard drug to get use to. Thats my only wish, is that they could reduce the sustiva side effects somehow and make the med more user friendly. Just try to go with the flow.take care, good luck!

I am a flight attendant and I fly from Europe to America. I have to work many nights. In fact, many times I start working at 2.00 am (european time) but I always keep my schedule and take my meds at my 24.00 hours wherever I am.I was in Ecuador these days (7 hours less) so I had to take them at 17.00 local time because it was 24.00 for me. But it is easy top do so.I am on sustiva and truvada. As long as i take them on an empty stomach, I have no side effects and I can eat 45 minutes after taking them.